Vol 34, No 9 (2023)

The incidence of oncogynecological pathologies, including endometrial cancer (EC), tends to increase, especially among women of reproductive age. Treatment of EC involves radical surgical intervention, as well as combined chemoradiotherapy according to indications, which has a traumatic effect on the physical, psycho-emotional, and social well-being of the patient. A comprehensive personalized rehabilitation program significantly improves the quality of life (QoL). However, the issue of introducing restorative measures into еру clinical practice remains open.

Of great practical interest is the possible impact of diet and availability of a number of nutrients on the quality of sleep and the risk of its disorders in children. The review presents information on the relationship of sleep characteristics to the intake of the most important macro- and micronutrients into the body. It discusses the positive effect of amino acids, primarily tryptophan and its derivatives: serotonin and melatonin, on sleep indicators. The possible effects of fats and carbohydrates on the quality and structure of sleep are considered.

The significance of the availability of micronutrients, including magnesium, iron, and copper, is analyzed. The role of group B vitamins and vitamin D in improving the quality of a child's sleep is discussed. There is information on the possible pathophysiological and pathochemical mechanisms that form a basis for the relationship of sleep characteristics to the intake of a number of nutrients into the body. The role of breast milk in ensuring the natural ontogenesis of a child's sleep and in improving the quality of sleep is separately considered.

Objective. To assess patients' adherence to therapy with warfarin, to identify main reasons for its discontinuation or lack of timely the international normalized ratio (INR) monitoring.

Material and methods. The database of anticoagulant rooms controlling the intake of warfarin was analyzed. Adherence to warfarin therapy was assessed by interviewing patients. The data were statistically processed using the computational program Statistica v10.0.

Results. Only 20.6% of the patients who were prescribed warfarin to prevent thromboembolic events in the presence of non-valvular atrial fibrillation (AF) continue to take it. Of them, 69.2% regularly monitored INR. In the subgroup using warfarin after artificial heart valves had been installed; 32.4% of the patients continued its outpatient use; in 24.5% of them had an INR within the therapeutic range of ≥70%. There were main reasons for the termination of INR control: the fear of visiting polyclinics and anticoagulant rooms due to the epidemiological situation in 2021-2022; the presence of queues in the polyclinics; residence change and the inability to control INR within walking distance; movement difficulties experienced by patients with limited mobility; most patients stopped INR control because they were not properly informed about its necessity and the possible consequences of uncontrolled intake of warfarin.

Conclusion. Among the patients with non-valvular AF and prosthetic heart valves who were prescribed warfarin, 74.9% stopped taking it after discharging from the hospital. The patients receiving warfarin in an outpatient setting controlled INR in ≤83.3% of cases.

Type 1 diabetes mellitus (DM) (T1DM) in children remains one of the most important problems of endocrinology due to the constant increase in new cases of the disease.

Objective. To analyze the main epidemiological indicators (morbidity and incidence rates) of DM among children and adolescents who live in the closed administrative-territorial entity (CATE) and to compare the data from the federal DM register with those in that of the Krasnoyarsk Territory and Russian Federation to assess trends and to plan further work on the provision of specialized medical care, as well as the rational use of material and human resources.

Material and methods. The data of regional DM register in the past 10 years (2010–2021), as well as those in the outpatient records of T1DM who lived in the CATE of the Krasnoyarsk Territory were studied and analyzed. Morbidity and incidence rates were calculated; a comparative analysis was carried out. The data available in the register and medical documentation were analyzed and there was evidence for the age and gender characteristics of a manifestation of the disease.

Results. The incidence of DM among the pediatric population in the CATE exceeded the average statistical indicators in the Krasnoyarsk Territory. The age structure of sick children was dominated by a 15–18-year group. The gender characteristics included higher morbidity rates among the boys in the entire group of the examinees. An assessment of the incidence of DM revealed its stable increase with the maximum figure by 2021.

Conclusion. The presented data and the analysis of indicators can be used in further observations and for the comparison with future data on the incidence of DM in children in the CATEs.

Objective. To evaluate the effectiveness of complex pregravid preparation programs, including sodium chloride baths, electropulse therapy and manual therapy, and their impact on the endometrium, uterine blood flow parameters according to ultrasound and dopplerometry, as well as on the pregnancy rate in patients with chronic endometritis.

Materials and methods. The randomized study included 95 patients with chronic endometritis aged 28 to 45 years. 32 women of the main group received a complex of electropulse therapy procedures (10 procedures), sodium chloride baths (10 procedures) and manual therapy (5 sessions). 32 patients of the comparison group received treatment consisting of electropulse therapy and sodium chloride baths. In 31 patients of the control group, restorative treatment was used, including electrical impulse therapy and fresh baths.

Results. The value of the arterial perfusion index increased in the comparison group by 2.36 times (p<0.05), and in the main group by 2.6 times (p<0.05). In the control group, this indicator did not change significantly.

The systolic-diastolic ratio in the right uterine artery in the control group decreased by 6.18% (p<0.001), in the comparison group - by 9.18% (p<0.001), in the main group by 20.8% (p<0.001). 0.001). The indicator of systolic-diastolic ratio in the left uterine artery in the control group decreased by 7.44% (p<0.001), in the comparison group - by 9.27% (p<0.05), in the main group by 20.4% (p<0.001). The decrease in the systolic-diastolic ratio after treatment in the main group significantly exceeded similar indicators in the control group and the comparison group (p<0.001).

Conclusion. Sodium chloride baths and manual therapy as part of complex restorative treatment help to improve the structure of the endometrium and increase the volumetric blood flow of the uterus. Manual therapy reduces vascular resistance, which is manifested in a decrease in the systolic-diastolic ratio in the uterine arteries.

Objective. To study the structure of somatic morbidity and comorbidity in pregnant women living in the Khanty-Mansi Autonomous Area and to evaluate its impact on the severity of the course of novel coronavirus infection (NCI) and the outcomes of pregnancy.

Subjects and methods. A single-center prospective comparative study was conducted in the groups of women who experienced NCI in the third trimester from March 2020 to April 2022 (n=149). The patients were divided into groups: 1) mild NCI (without pneumonia) (n=78); 2) moderate NCI (n=52); 3) severe NCI (n=19).

Results. A statistically significant relationship was found between the presence of obesity concurrent with diseases of the urinary system, the upper respiratory tract, and severe NCI (p=0.04). Chronic pyelonephritis in the patients’ history was statistically significantly associated with oligohydramnios (p<0.001) and gestational diabetes mellitus (GDM) (95% confidence interval, 1.070–8.883).

Conclusion. Ninety (60.4%) pregnant women who had experienced NCI were found to have a history of somatic diseases; the comorbidity index was 1.9. The concurrence of endocrine and urinary diseases with chronic upper respiratory tract ones significantly worsened the course of NCI and led to placental disorders and GDM.

Objective. To consider the evidence-based approaches to treating virus-associated lung tissue lesions, the rationale for using the Markov model to evaluate the clinical and economic efficacy of interleukin (IL)-6 (IL-6) receptor inhibitors in patients with COVID-19.

Subjects and methods. To evaluate the clinical and economic effectiveness of using the receptor inhibitors in COVID-19 patients, the investigators formed two groups: 1) 187 patients received the standard therapy; 2) 104 patients had IL-6 receptor inhibitors in addition to the standard therapy.

Results and conclusion. The logistic regression method was used to determine the need for prescribing these drugs depending on the individual characteristics of patients, the key points were the length of a patient's stay in the intensive care unit, as well as the duration of oxygen support. In the context of new challenges to the healthcare system, it is necessary to further search for comprehensive methods of monitoring the condition and prognosis with promising ways to assess the validity of using therapeutic procedures and drugs.

Objective. To study the impact of the duration of distance learning on the quality of life (QOL) in primary school children.

Subjects and methods. An open cohort prospective study of primary school children and their parents was conducted using the Pediatric Quality of Life Inventory PedsQL 4.0^ТМ. A study group included 182 children (and their parents) who had learned in the distance format for 6 months (Lugansk). A comparison group consisted of 234 primary school children (and their parents) who had had distance learning for 2 months (Rostov-on-Don).

Results. The analysis of the results indicated that the first ranking place showing in discomfort and the greatest decrease in the QoL indicators in the study group was displayed by the physical functioning scale (6-month distance learning). The second ranking place belonged to school functioning, the level of which in the study group decreased by 1.27 scores compared to the baseline level. The third ranking place is shown by social functioning of primary school children, the indicators of which in the study group were 18.49 scores lower than the initial levels.

Conclusion. Prolonged education of primary school children in a distance format affects all aspects of QOL. The greatest decrease in QOL indicators in younger schoolchildren during the formation of basic learning skills is observed in the field of physical, school and social functioning. The assessment of QOL by primary school children and their parents differs.

Diabetes mellitus (DM) is one of the most common and important non-communicable causes of morbidity and mortality in the world, whereas diabetic retinopathy remains a serious threat to vision among the able-bodied population. The introduction of simple screening tests and studies into the daily practice of an ophthalmologist will allow one to identify the first functional abnormalities in the eye at an early stage and to timely refer them to the relevant specialists, as well as to implement preventive measures.

In modern medical practice, the issues of asepsis and disinfection in operating and dental rooms are becoming particularly relevant in the context of preventing airborne infections. Given the rise in antibiotic-resistant microorganisms and the increasing number of invasive medical procedures, the need for effective methods of asepsis and disinfection is becoming more evident. The review covers contemporary approaches and technologies aimed at minimizing the risk of infectious complications. Methods of ventilation and air filtration, the application of ultraviolet sterilization, and laminar airflows are discussed. Special attention is given to their effectiveness in various medical fields, including dentistry and surgery. The aim of the review is to systematize existing knowledge and formulate recommendations for further scientific study and clinical practice.